International journal of STD & AIDS
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Review Historical Article
Sexually transmitted disease/HIV health-care policy and service provision in Britain.
The objective of this paper was to discusses historical developments of sexually transmitted disease (STD)/HIV sexual health policies in Britain, principally from the 19th to the 21st century. Repeating trends were identified and a consideration of how history addresses today's urgent need for better management of sexual health is discussed. In January 1747, the first venereal disease (VD) treatment was established at Lock Hospital, London. ⋯ From 1918, treatment centres increasingly recognized the difficulties in persuading attendees to return for a complete course of treatment. AIDS in Britain wrecked havoc in the period 1981-86 with incidences of infection in several widely differing groups and public alarm fuelled by the media. In conclusion, education, advertising and public health counselling need to be moulded effectively so that the public recognize the real risks associated with unprotected sexual intercourse.
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Review
Partner referral tools and techniques for the clinician diagnosing a sexually transmitted infection.
Public health agencies have insufficient resources to trace and refer to medical evaluation the sexual partners of patients with sexually transmitted infections (STI). Only a minority of such patients receives formal sex partner referral services. Hence this responsibility rests, by default, with the diagnosing clinician or with the infected patient. ⋯ Clinician and patient obstacles to successful partner referral are discussed, and brief counselling techniques are suggested. Use of patient-delivered therapy, via medication or prescription (dispensed with appropriate warnings), probably serves to emphasize the urgency and importance of notifying partners. Successful referral to medical attention has been shown to help prevent re-infection of the index patient and to curtail community transmission.
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During the mid-1980s Australia experienced a remarkable decline in HIV incidence that can rightly be considered a public health milestone of global importance. The effects of this decline lasted for about 20 years and greatly benefited all Australians. In contrast, as we enter the mid-2000s, we see the global epidemic continues to intensify, HIV vaccines remain a distant possibility, and Australia is experiencing rising HIV incidence again. ⋯ The analysis reveals that the greatest decline in HIV preceded almost all substantive initiatives undertaken at the national level, which are often held responsible for Australia's successful early containment of HIV. In particular, dramatic declines were already well advanced and/or preceded (i) substantive growth in national HIV/AIDS prevention education funding, (ii) publication of the first National AIDS Strategy, (iii) establishment of key national HIV/AIDS bodies and (iv) promulgation of the 'Ottawa Charter'. Explanations for, and lessons learned from Australia's dramatic early declines in HIV incidence are discussed.
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In sub-Saharan Africa, traditional healers play a major role in providing for the needs of people, particularly in rural areas where western health care is unavailable. Despite a paucity of reliable figures to determine the prevalence of traditional medicine usage, it is estimated that some 70% of sub-Saharan Africans access traditional healers. ⋯ While there are few collaborative projects between traditional healers and biomedical health providers, there is an enthusiasm on the part of traditional healers to collaborate and learn from their western-trained counterparts. Collaboration is essential, given the changing epidemic of HIV and the dynamic relationship between the two health sectors.